Health

Health

A new report commissioned by the Australian National Council on Drugs (ANCD) has highlighted that the role of Australia's prisons need far greater levels of accountability and transparency, as well as a much stronger commitment to providing effective programs and treatment for people with drug and alcohol issues if we are to see any change in reoffending rates.

The proposed Needle and Syringe Program at the Andrew Maconochie Centre in the ACT provides a window through which to view attitudes towards prisoners’ health and their right to an equivalent health care system. The fierce objection to its introduction by prison officers highlights Corrections’ approach to prisoners’ health - as one of many competing interests. As progress to introduce an NSP, a tool proven to be highly beneficial to health, is slowed/potentially blocked by prison officers, it raises the question – does prisoner health come second?

As rates of Hepatitis C in correctional facilities reach levels sixty times that of the general population, it is imperative that the role of needle sharing in the spread of blood-borne communicable diseases is recognised and taken seriously. Some form of Needle and Syringe Program must be implemented to ensure that the duty of care that prison authorities owe to prisoners to protect them from foreseeable harm is fulfilled.

Australian law and international treaty obligations recognize that a person’s capacity to access health services must not be compromised by reason of imprisonment and that all people have a basic right to health. In 1990, the United Nations adopted the Basic Principles for the Treatment of Prisoners, at its core is the “principle of equivalence” which ascertains that prison health services must be of the same quality and meet the same standards as those of the outside community. As such, as highlighted by the World Health Organisation and the Joint United Nations Program on HIV/AIDS, the higher the rates of injected drug use and associated risk behaviours becomes in prisons, the greater the urgency for the introduction of needle and syringe programs becomes.

The National Drug Strategy approaches drug policy from the position of harm minimalisation, including the reduction of demand, supply and harm. Yet the strategies employed in prisons are highly inconsistent with approaches to illicit drug use in the community. The rates of Hep C infection, transmission and the use of shared needles in correctional facilities also serve to highlight these inconsistencies with rates in the wider community.

Prisoners have highlighted the need for the introduction of a NSP to Justice Action for decades as they would prefer to avoid infection rather than undertake expensive post-infection treatment strategies and should have the right to control their own health care. None of the goals of the NDS or the right to adequate healthcare should be lost because a person is incarcerated.

Many countries have established a variety of carefully controlled programs that allow prisoners who inject drugs to access sterile needles. First established in Switzerland in 1992, NSPs have been established in more than 50 prisons in 12 countries in Europe and Central Asia including:

Prisons have become the defacto mental institutions. Exclusion of the mentally ill is most starkly expressed in the government policy for expansion of the prison system; stigmatising the people held there and the blocking of community support for them.

The following resources offer information about HIV/AIDS in prisons around the world. Please refer to them for further guidance on the topic. Source: http://www.hc-sc.gc.ca/ahc-asc/pubs/int-aids-sida/hiv-vih-aids-sida-prison-carceral-4_e.html

The New South Wales Corrections Health Service (CHS) estimates that about 80% of prisoners have been imprisoned for offences related to legal or illegal drug use or committed whilst under their influence.

Drug Use in Prison Justice Action raises concerns about improper medication and treatments when these arise. Justice Action also supports calls for the use of non-custodial methods of punishment for drug users and the decriminalisation of drugs. In conjunction with the Victorian based Peoples' Justice Alliance, Justice Action successfully had the International Conference on Penal Abolition (1997) resolve that illegal drugs should be decriminalised.

Further, the national conference made similar resolutions. In Justice Action's submissions to the Royal Commission into the New South Wales Police Service, it was argued that drug law reform would remove the incentive to the endemic police corruption that exists and should be recommended. Further, Justice Action endorsed submissions on this issue by other organisations to the Royal Commission.

Intellectual disability & the criminal justice system

Beyond Bars - Fact Sheet 10 People with an intellectual disability are being drawn into the criminal justice system at an alarming rate. People with intellectual disability make up between 1 and 3% of the general population, but represent between 9 and 13% of the NSW prison population. As many as 23% of people appearing before NSW Local Courts on criminal charges may have a mild intellectual disability or borderline intellectual disability.

I can speak from first hand experience about the lack of health care within the prison service, albeit from the perspective of the much over populated female estate.

The job of being a prison doctor is hard. Many inmates are drug users or self harmers. They pull fast ones to get legal prescriptions to alleviate the gnawing need for heroin or crack cocaine. They try to get sick notes so they do not have to work. However, not all prisoners are addicts or skivers, yet we are treated as if we are.

The Laws of the Australian Government recognise that a person's capacity to access health services is not compromised by reason of imprisonment and that all people have a basic right to health. This recognition is evidenced in Australia's international treaty obligations.

There is little doubt that prisoners are amongst the unhealthiest people in Australia. The New South Wales Corrections Health Service (CHS) estimates that about 80% of prisoners have been imprisoned for offences related to legal or illegal drug use or committed whilst under their influence. 14% of prisoners are indigenous, who although only despite constitute less than 2% of Australia's population are internationally recognised as living in Third World conditions. 18% of prisoners are of non-English speaking background.

The Laws of the Australian Government recognise that a person's capacity to access health services is not compromised by reason of imprisonment and that all people have a basic right to health. This recognition is evidenced in Australia's international treaty obligations.

There is little doubt that prisoners are amongst the unhealthiest people in Australia. The New South Wales Corrections Health Service (CHS) estimates that about 80% of prisoners have been imprisoned for offences related to legal or illegal drug use or committed whilst under their influence. 14% of prisoners are indigenous, who although only despite constitute less than 2% of Australia's population are internationally recognised as living in Third World conditions. 18% of prisoners are of non-English speaking background.